The Many Roles of a Ranch Nurse

Nursing care at Dakota Boys and Girls Ranch is unlike any other nursing job. I am often asked, “What do the nurses do at the Ranch?” and I am never quite sure how to answer. One day, nursing staff can be found scheduling appointments and managing medications. The next day, we might be out playing a softball game with the kids. No two days are ever the same!

One of the main responsibilities of Ranch nurses is to obtain medical care for the residents. Many of our residents come to us without a consistent history of medical appointments. It is not unusual for our children to have never been to the dentist or had an eye exam. These same children are unaware of how often they should receive medical care, or even how.

We schedule preventative health care appointments for every child who comes into our care. These appointments include: dental exams, vision testing, physicals, vaccinations, and lab work. Scheduling the appointments is easy. The difficult part is to calm our kids’ fears and help them understand what to expect during and after each appointment. The doctor’s or dentist’s office can be a scary place if you’ve never been there before, especially if you’ve experienced physical or sexual abuse, as many of our children have.

We teach our kids about preventative health care, for when they live on their own. How often should they have a physical, see the dentist, or have an eye exam? Most of our kids don’t know these things—we take extra time to teach them how to manage their own health care. When they leave our care, we often give our phone number to children, and encourage them to call if they have questions.

One story that illustrates the many different roles nurses have at the Ranch is about one of our young boys. He came to us with braces on his teeth that were severely damaged and broken. He had removed the wires himself, as they were broken and cutting his cheeks. The dentist told us the brackets needed to be removed or they would cause severe decay to his teeth and create long-term dental issues. Because he received the braces out-of-state, North Dakota Medicaid would not cover the removal, and his parents didn’t have the resources. Nursing staff worked closely with the Ranch’s financial team to access donor funds—which paid to remove the brackets and make retainers.

After it was all taken care of, the child wrote a note to us saying, “Thank you very much for paying to get my braces off. That really took a lot of stress from my parents. I couldn’t have got them off without your help.”

Ranch nurses also assist the residents with basic self-care and hygiene. It is not uncommon for children to come to the Ranch without a good understanding of how to take care of their body, both inside and out. Nurses, along with youth care workers, teach Ranch kids basic body care. We teach them how to clip their fingernails, care for themselves during their menstrual cycles, and properly shower.

We teach all of these things in a way that meets the specific needs of each child. Children who are visual learners may benefit from a colored chart depicting the steps in taking a shower. Other children may learn best through a verbal discussion. We meet kids where they are at, and strive to adapt our teaching to suit each child’s learning style.

Most of our kids have little knowledge of healthy exercise and nutrition habits. The nursing department, along with the wellness department, teach the youth all about healthy eating and exercise—the types of food that are good/bad for you, healthy portions, exercise options that fit into their daily routines. Nurses often attend the wellness and recreation classes with the kids. Those classes have been some of the best moments I have shared with youth at the Ranch.

Nursing staff at the Ranch work closely with each child’s treatment team to create a treatment plan, and provide lifelong lessons in healthy living, medical care, medications, and self-care.